Explain to me why you offence is caused by saying things like 'mildly autistic' etc.

[Purpleturtle45]

If ASD is a spectrum why do people commonly disagree that you can be mildly autistic or severely autistic etc.

My daughter is diagnosed with ASD, however you wouldn't really know unless you knew her well. She goes to mainstream school and copes well with everyday life most of the time so to me I would say she is mildly autistic but I often see people getting ripped to shreds on here for using that term.

Genuinely wondering how 'spectrum' can literally be in the title of the condition but people disagree there can be different severities.

I've never seen either of those things happen.

I have seen people say they don't feel their own autism is mild because of (reasons) or that they struggle a lot with (thing) - they've never said that nobody else struggles more than they do. Just that they don't feel their condition is mild - and they have every right to feel that way - it shouldn't have any impact on the way people view your children or people with more profound needs.

Nobody on this thread has denied profound autism or "mild" autism that I can see - they just dislike the use of the term "mild" and would prefer something else was used instead.

Although many of the ‘something elses’ are basically synonyms. ‘Low needs’ ‘less severely affected’ ‘high functioning’. These are all terms trying to express the same concept. Quite why ‘mild’ in particular should attract such condemnation is hard to understand especially as some posters have said that they do use it about themselves or their DC as a shorthand and don’t find it offensive.

I think because "mild" has connotations of "no big deal" whereas the other terms are a bit more loaded (to my mind, anyway).

People have already said multiple times that how they choose to define themselves is very different from having total strangers deciding to define you that way with no knowledge.

Not sure if thats aimed at me but in case it is then my argument is that people are saying that mental health needs/ presentations such as self harm or OCD are a reason that someone’s autism might be considered severe although they are not intellectually impaired and otherwise are able to function. Whereas I would still classify them as having mild (or whichever other term is acceptable low needs, high functioning etc) autism but with a mental heath comorbidity.

The reason this might be an important distinction is that mental health comorbidities might be able to be treated whereas autism itself cannot be per definition. If we are saying that all of these issues are an intrinsic part of autism (although they are not in the core definition) then people might miss out on opportunities for treatment and/ or be excluded from a service.

Well earlier up the thread a PP was claiming "people like me who'd you'd class as "mildly autistic" still have the same struggles as someone who'd you class as "severely autistic"". (11:18 yesterday)

And this whole debate - which has been a long, trending thread - has been in response to the question "why do people commonly disagree that you can be mildly autistic or severely autistic"?.

Oh no. Not you. I agree with you.

Although i can still see that even if they weren't treated as different, the symptoms can still be treated. But i agree with you that if they're always seen as part of autism, many health professionals would no longer consider them as something to look into separately.

I think people are disagreeing with the terminology "mildly autistic", not with the idea that some people struggle more than others.

I have what you would term "mild autism" and have often referred to myself as mildly autistic but don't appreciate other people deciding how bad my autism is when they have absolutely no idea.

It's not up to other people to decide how I refer to myself, and me saying I have severe struggles around X is in no way meant to dismiss those who struggle even more than I do.

Autism is part of a person, but you can certainly support (treat?) aspects of it. Sensory issues for example can be addressed in multiple ways. Skin brushing to address sensory defensiveness is an example.

Having a brain that has a tendency towards OCD is also inherent to a person. There have been many studies showing that OCD and autism have genetic, neurobiological, familial, and behavioral commonalities.
As other conditions like dyslexia and autism do. I don’t think you can separate them so easily and professionals often don’t separate them in terms of treatment …it’s far more difficult to find a professional willing to treat your ocd when you’re autistic.

Unfortunately several people in the thread were insisting that they struggle just as much or even more than severely autistic people.

People are free to insist on whatever they like.

You're free to ignore them if it upsets or offends you. Responding and getting yourself wound up only hurts you.

But that’s the case now? At least in Ireland where I am.

My adult son has recently been refused help from adult mental health services precisely because he’s autistic. I am quoting! They said he needs to seek help for his MH issues from autism services. They can’t cater for his needs because he’s autistic. (He doesn’t have an intellectual disability and he’s usually as competent verbally as anyone else, though will go mute when stressed.)

They don’t seem to know or care that autism services currently aren’t set up to address MH issues either.

When he was a child he fell between CAMHS and autism services too, each trying to pass the buck when it came to his MH issues.

Also much more difficult to find someone in private practice to treat him, especially when he was a child.

I don’t think this is unique to Ireland btw. I have seen others on MN struggling with precisely the same attitude from services.

The narrative that all autism is equal benefits those with lower support needs, who are the ones dominating the conversation. Those who are non-verbal, those will never be able to live independently, they don't get to contribute to the conversation. Not to say it's ever easy, but no-one in the latter category, or their families, are saying things like "autism is a superpower actually."

it’s far more difficult to find a professional willing to treat your ocd when you’re autistic.

Which is part of the problem and why they should be separated as sometimes, some symptoms can be treated which in return helps the autistic person. My GAD is part of me as well as autism but if it wasn't treated i wouldn't be able to cope as I am. So to me it really doesn't matter if it's considered part of my autism or separate, treating the issue is all that matters, not ignoring it because it's autism.

@shinygolden
If it comes to medication, it would be the same treatment but for therapy, i do agree with professionals (and autistic individuals who say this too - I've also lived it myself) that the same standard therapy treatment doesn't usually work for autistic people. So it's best for autistic services to cater to that part of MH as well, ideally or MH services be more autism-aware and inclusive.

I have never come across any other person or group of people who object to the descriptor "mild" being applied to people who are a lot less obviously impacted by the condition than others with the same condition.

Literally never, while having had direct involvement with myself, close friends or family with sight fov limitations, glaucoma, amblyopia, deafness, two types of arthritis, parkinsonism, depression, hypertension, benign prostate hyperplasia, prostate cancer, stroke, atrial fibrillation, heart valve defects, hyper and hypotension, aneuryism, hypermobility, skin cancer and probably some others I've forgotten.

Never, in all that lot. The only people and group I've ever heard complain about the use of the word "mild" as a comparator (as opposed to as an excuse not to provide treatments that are available and effective, which is a complaint about the treatment not the accurate use of a word) are the neurodiverse.

Please bear in mind that I am one.

Well then he must insist that they justify on what grounds they are refusing to treat his mental health condition. In England (not sure about Irish laws) it would be covered under the equalities act. They are obliged not to turn him away on the grounds of his disability but to make reasonable adjustments for it.

So it's best for autistic services to cater to that part of MH as well, ideally or MH services be more autism-aware and inclusive.

But they don’t and they aren’t.

What you said is fine, but what happens in practice ime is that the professionals won’t treat OCD using therapy at all as they say they’re unqualified to do so. Either unqualified regarding autism or unqualified regarding MH.

In practice you can’t separate the conditions to treat them as pp was suggesting. Meds are the exception but DC was put on those with the strict caveat that they were to be used only until the CBT therapy had a chance to work. The CBT therapy he can’t access. Because he has an autistic brain.

We are working on it.

Sometimes I’m not sure what I’m fighting for…to get access to professionals who have already told me they are unqualified to treat him?

Ours is not an unusual situation. Those with autism are often very let down by CAHMS in the UK also.

It’s excuses from overstretched services. CBT does work for people with autism. It just requires some reasonable adjustments. Surely it’s better to try an evidence based therapy that has some chance of working than to have nothing at all? If people go around perpetuating the unproven narrative that CBT doesn’t work for anyone with ASD it’s just going to mean they get even less services than they already had.

And it’s bizarre to suggest that meds are only until a person can access therapy because they work synergistically and the best treatment is to combine the two.

I really don't think I said it "doesn't work for anyone with ASD". It just doesn't work for everyone, though people must try first to see what works for them.

But it's a fact that therapists must adapt their advice and treatment to autistic patients otherwise they're telling the autistic person to do something they naturally are not wired to do. It's like telling someone to start walking backwards.

Even the CBT therapist i had years ago said this to me. CBT didn't work for me and many other autistic people I've encountered talking about it, but I'm sure it works for some. GP suggested EMDR and other autistic adults swear by it. Maybe it will work where CBT doesn't. I haven't tried it myself.

I think they're letting you down. I'm not sure why they're insisting on withholding other forms of treatment but I'd be complaining about this. I agree with you that it's not uncommon to be let down by CAMHS, etc. People do take these things up with the right authorities and make complaints here in England but i don't know how far they go.

I find it unhelpful. I was going to work for a new cleaning client and my boss described her as "slightly autistic". She was just autistic, but there was no slightly about it. I actually found her incredibly interesting and a wonderful person. I'd never met a elderly autistic woman before. Luckily having several autistic kids I didn't find her being autistic a problem when it came to working for her

It’s the mental health professionals saying this. Also autism services. Not people in general.

They say a modified approach needs to be used. That it needs to be very specialised and directed.

They’re not trained in the modified specialised approach. They don’t even seem too clear on what it is exactly, except that they aren’t able or willing to provide it.

Yanbu OP. There literally is a clinical way this is described. There are "levels" of autism as defined in the DSM-5.

Our course people may have diverse traits or a spiky profile of impairment in different areas but you will also get people who are severly impaired in more/all areas, who also have learning difficulties, and these individuals are more likely to meet criteria for L3 autism (classic kanner) than someone who is verbal and able to manage mainstream school/work etc

Wonderfully put. Wholeheartedly agree.

Mild is how other people perceive autism within particular people, it isn't how it is experienced.

Of course people with high support needs should be given that support, people having low support needs and also being given support isn't taken away from people who require completely different and substantial support.

It's also OK for all of us to say there just isn't enough support no matter how needs present. There isn't. Removing support from people with lower support needs doesn't automatically mean that people with higher support needs are supported when their needs are completely different.

For a lot of people with lower support needs, their needs are often lower because they have a specific social scaffolding around them and if that social scaffolding was removed they could well need more substantial support anyway.